Alter C L, Schindler B A, Hails K, Lamdan R, Shakin Kunkel E J, Zager R
Temple University Cancer Center, Philadelphia, PA 19140, USA.
Psychosomatics. 1997 Mar-Apr;38(2):93-7. doi: 10.1016/S0033-3182(97)71476-2.
Recently, the Commonwealth of Pennsylvania initiated plans to implement a mandated behavioral health carve-out program for Medicaid-eligible persons. The Consultation-Liaison Association of Philadelphia (CLAP) discovered that there was no provision for the coverage of psychiatric services for patients with concomitant medical illness. As a result, the authors responded by initiating a series of actions aimed at ensuring inclusion of such services as part of mental health services to be delivered. CLAP developed a brief position paper that includes a description of the need for such services, the types of services typically delivered, the impact of psychiatric input in the medical setting on costs and other outcomes, and a specific set of recommendations. These efforts have lead to the inclusion of consultation-liaison services in the new plan. A description of recent changes in Medicaid, including expansion of managed care plans, the status of mental health carve outs, and the possibility for inclusion of psychiatric consultations for the medically ill within these plans, is detailed.
最近，宾夕法尼亚州开始计划为符合医疗补助条件的人群实施一项强制性行为健康分离计划。费城咨询联络协会（CLAP）发现，对于患有合并症的患者，精神科服务的覆盖范围没有相关规定。因此，作者们采取了一系列行动，旨在确保将此类服务纳入待提供的心理健康服务之中。CLAP撰写了一份简短的立场文件，其中包括对这类服务需求的描述、通常提供的服务类型、精神科介入医疗环境对成本及其他结果的影响，以及一系列具体建议。这些努力使得咨询联络服务被纳入了新计划。文中详细介绍了医疗补助近期的变化，包括管理式医疗计划的扩展、心理健康分离的现状，以及在这些计划中为患病者提供精神科会诊的可能性。
